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NCH Healthcare System
HIMSS 2015
Michele Thoman, RN - CNOSarah Richardson - CIO
Jeff Dindak – Sr. IT Director
2 hospitals (715 beds)
An alliance of 650 physicians and medical facilities
throughout Collier County and Southwest Florida
Extensive inpatient and outpatient services
In 2014, the system had 28,938 admissions,
93,673 ED visits, 3,418 births, 453 open heart
surgeries, nearly 11,000 surgical procedures and
over 3,000 on staff
Member of the Mayo Clinic Care Network
Non-for-profit, multi-facility healthcare system in Naples, Florida
NCH Healthcare System
1991 2000 2010
NCH becomes a
Cerner Lab/Rad
Client
1998:
NCH
implements
Cerner’s CDR
2001:
HIM
CPDI
MRP
Clinical Doc
& Orders
2003:
ED Doc
Tracking
2005:
Pharmacy
eMAR
Surgery
2007: :
CPOE
Physician Doc
2009:
Scheduling
(replacing
SMS)
RHO ITWorks
2011-12:
Rev Cycle, Registration
MU Stage 1
Care Management
HIE, Patient Portal
Women’s Health
Smart Rooms
Infection Control & Rehab
Most Wired
2010:
Infrastructure
System Migration
Domain Upgrades
Workflow Opt.
Device Int.
Mobility
NHIQM/Quality
Ev. Based Care
Lab Upgrades
HIMSS Stage 6
Cerner IT Works
NCH’s HCIT Journey 2013-14
CPOE Mandate
Smart Room Exp.,
CareAware Connect,
Med Rec, CareAware
5.2, BMM, Blood Admin
Physician Playbooks
Ambulatory EMR
HIMSS Stage 7
2015 IT Project Roadmap
Anesthesia
Acuity
PC Endoscopy
ProVation
Infection Prevention Uplift
NHIQM Upgrade
Physician Playbooks
Depart Process Optimization
Lab Cardiac Panels
Patient Portal Phases 2 & 3
Millennium 2015 Upgrade
Concurrent Coding
Smart ED
Infusion Management
Alarm Management
Stryker Bed Integration
HIE Expansion
Telemedicine
ICD-10
eSignature
Care Compass
PowerChart ECG
Dynamic Documentation
Full Smart Room Technology Suite
Phase I – March 2012
Vitals Link – Integrated Vitals Collection
Staff Link – Staff Assignment
Alert Link – Secondary Alerting to Caregiver’s Phone
Phase II – August 2012
Room Link – Integrated Digital Signage
My Station – Enhanced Patient Engagement
Capacity Management – Provider/Resource Presence Detection
Phase III – October 2012
iAware – Aggregated, personalized view (dashboard) of all information relevant to patient care
Phase IV – October 2013
Smart Room Expansion to an additional 71 patient rooms (163 total)
CareAware Connect – Development Partner
2.4
2.45
2.5
2.55
2.6
2.65
2.7
2.75
2010 2011 2012 2013
NNH
DNH
NDNQI RN Staffing & Resource Adequacy
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Impact of Sepsis ImprovementsActual # Mortalities Projected # Mortalities
$5.8 million cost avoided
275 lives saved since 2012
0%
10%
20%
30%
40%
50%
Jan…
Feb…
Mar…
Apr…
Ma…
Jun…
Jul-1
2
Aug…
Sep…
Oct…
No
v…
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Jul-1
3
Aug…
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Sepsis Mortality (Actual vs Baseline)Actual Sepsis Rate Baseline / Proj Rate Linear (Actual Sepsis Rate)
$5.8 million cost avoided
275 lives saved since 2012
Join the Movement
SOUTHWEST FLORIDA
Blue Zones Project™
BLUE ZONES
Move Naturally
Right Outlook
Eat Wisely
• Wine @ 5
• Plant Slant
• 80% Rule
Connect
The Power 9Lessons for Living Life Longer, Better
• Loved Ones First
• Belong
• Right Tribe
• Downshift
• Sense of Purpose
16
Blue Zones Awareness
RESULTS – WHAT TO EXPECT
•Measurable increase in Well-Being of the population
•Lower Healthcare Costs
• Improved Productivity
•Community seen as innovator in Preventative Health
•Alignment for Grants, Gifts, and Funding
•Less Tobacco Usage
•More Active Population – Walking, Biking, and Moving
• Increased consumption of fruits and vegetables
•Local, regional, and national media
The 5 Elements of Well-Being
Liking what you do each day and being motivated to achieve your goals
Having supportive relationships and love in your life
Managing your economic life to reduce stress and increase security
Liking where you live, feeling safe and having pride in your community
Having good health and enough energy to get things done daily
Purpose Social Financial Community Physical
Purpose >
Social >
Financial >
Community >
Physical >
Well-Being: The North Star for Accountability
• 25-year commitment initiated January 2, 2008
• 500 telephonic “community” surveys completed per day, 7 days/week
• 2,000,000+ completed surveys• For results based on this sample of respondents, the maximum 95% margin of
sampling error is ±0.2 percentage points
• Design support and oversight from leading behavioral economists, psychologists, and experts in psychometric survey design and statistical analysis
• Largest and most comprehensive health survey and database
Purpose
Social
Financial
Community
Physical
Cost Goes Down When Well-Being Goes Up
Source: “Evaluation of the Relationship Between Individual Well-Being and Future Health Care Utilization and Cost” Population Health Management, Volume 15, Number 00 2012. Patricia L. Harrison, MPH, James E. Pope, MD, Carter R. Coberley, PhD, and Elizabeth Y. Rula, PhD
1 Point =
2.2% likelihood of hospital admission
1.7% likelihood of ER visit
1.0% likelihood of incurring healthcare costs
Population Well-Being
Performance Goes Up When Well-Being Goes Up
10 %Workforce Well-Being
5% fewer unscheduled absences
24%lower presenteeism
5%higher reported job performance
6%more days of ‘best work’ in 28-day period
Source: “Evaluation of the Relationship Between Individual Well-Being and Future Health Care Utilization and Cost” Population Health Management, Volume 15, Number 00 2012. Patricia L. Harrison, MPH, James E. Pope, MD, Carter R. Coberley, PhD, and Elizabeth Y. Rula, PhD
Beach Cities Well-Being Climb!
0
0.5
1
1.5
2
2.5
3
3.5
2010 2011 2012
Beach Cities Well-Being Climb
Finklestein, E.A., Trogdon, J.G., Cohen, J.W., and Dietz, W. (July 2009). “Annual Medical Spending Attributable to Obesity: Payer- and Service-Specific Estimates.” Health Affairs 28(5) w822-w831.
Solberg LI, Maciosek MV, Edwards NM, Khanchandani HS, Goodman MJ. Repeated tobacco‐use screening and intervention in clinical practice: health impact and cost effectiveness. American Journal of Preventive Medicine, 2006;31(1):62‐71.
Beach Cities Well-Being Jump by the Numbers!
What it means?• $2.35M h.care savings₁• $8.03M savings in work loss
productivity
What it means?• $6.97M h.care savings₂
₁Finklestein, E.A., Trogdon, J.G., Cohen, J.W., and Dietz, W. (July 2009). “Annual Medical Spending Attributable to Obesity: Payer- and Service-Specific Estimates.” Health Affairs 28(5) w822-w831.
₂Solberg LI, Maciosek MV, Edwards NM, Khanchandani HS, Goodman MJ. Repeated tobacco‐use screening and intervention in clinical practice: health impact and cost effectiveness. American Journal of Preventive Medicine, 2006;31(1):62‐71.
Well-being Analysis of Florida Counties
Top Quintile
2nd Quintile
3rd Quintile
4th Quintile
5th Quintile
Building Momentum in Naples to Set the Stage for Southwest Florida
32
• Positive engagement of city leadership,
business, media, and other community
sectors
• Opportunities to leverage current
community efforts and partnerships
• Great variation in well-being within
Naples
Questions?
33
Join the Movement
SOUTHWEST FLORIDA
Blue Zones Project™